My First Dental Visit

NOTE: This blog contains my personal opinion based on nothing more than experience as a general family dentist.

When, why, how and what not to do!

You may have been told many things in the past about your first dental visit by friends, neighbours, family and other professionals such as maternal nurses or doctors. Much of this information may seem conflicting or contradictory but there is no right or wrong way to approach your child’s dental visits! What suits one child may not suit another so please view the following information as a guide, as only you, being the parent, are in the best position to decide on the most appropriate approach for your child.

Whilst I am no child psychologist, and do not proffer to be a children’s dental specialist (paedodontist), having treated hundreds over the years and bringing two up with my wife Rachel, I feel qualified to be able to offer a few tips and tricks to consider when bringing your child to the dentist for the first time. It may seem daunting for you, your child (and me), but give these thoughts some consideration and we will all get through it unscathed!

Our goal as dentists is to develop an awareness and belief in your child of the benefits of regular, routine, preventive check-ups. This familiarisation may be carried out over several visits in an environment conducive to happy, stress free acceptance of future dental treatment. i.e the ability to go to the dentist without freaking out!

I am constantly amazed by the kids that walk through the surgery door each day! I am aware that I have not seen everything yet which makes my job so interesting and satisfying. No amount of reading textbooks and undergraduate studies prepares you for the unique challenges faced by each child as they enter the surgery. Every day I am reminded of one of the great movie quotes of all time from Forrest Gump…

I can usually predict what I will get with the adults, but the kids… Well, they just keep me on my toes!

So each child presents and reacts to situations in a unique and special way so it is up to us as professionals and you as parents to manage them in the most appropriate manner depending on their own individual personalities. Please don’t get disgruntled or disappointed with yourself or child if things don’t go to plan! Remember there is always a plan B!

Please do not underestimate the importance of your child’s first teeth (often called primary, baby or milk teeth) and bear in mind that many of these teeth will still be present until your child reaches early teenage years. They can still rot and cause pain if not looked after. This is why most dentists place so much emphasis on seeing you and your child at an early stage so they can provide appropriate, preventive advice.

There is no single, perfect way to approach the first few visits, and whilst I do not profess to having all the answers, I do have a few general management principles I always adhere to…

RESPECT

EMPATHY

TELL / SHOW / DO (a technique for providing treatment)

Obviously management will change if the child presents as an emergency tooth ache/ trauma but for general check ups, here are my tips for your child’s first experience of the dentist…

Have regular contact with your dentist yourself whilst you are pregnant!

Mums (and dads)-to-be should feel comfortable asking for advice from their dentist BEFORE the child is born. Examples of questions to ask are:

What forms of dentistry is safe during pregnancy?

Is the local drinking water supply fluoridated?

When can you expect to see their first teeth?

Is there anything special or different that I need to do when I see the first teeth?

Telling your dentist you are pregnant (especially if you are a woman) is very important as it may change the way you are managed. E.g. Non-essential X-rays may be delayed and certain medications may be avoided when you are ‘expecting’.

Bring your baby to the clinic when you have a dental check-up!

We try to schedule mum’s routine check-up for a few months after the happy day. This allows all the hullabaloo to calm down and dad has mastered driving a pram! (Don’t laugh- I have seen some these days that could double for 4wd vehicles!).

I encourage parents to bring their new baby in at this early stage so they gradually get used to the sights and smells of the clinic. These initial appointments are all about acclimatising your child with the new surroundings so that if they really do need treatment for toothache or trauma in the future, they know they will be going to a familiar place for help and are not freaked out so much by that person with the funny mask!

Before anyone writes in and asks for the evidence for taking this approach, I must confess that I base this hypothesis on nothing but my own clinical experience. I do qualify this by saying that most of my well adjusted, young patients have been attending since before they could walk and often before they were born!

Given prevention is better than cure, attendance at this time is ideal from my point of view or at least within the child’s first year. However, if you are not in a position to have regular check up and your child’s actual first visit is when they are older then all is not lost! Attending later when your child can make some sense of what is going on is totally fine also. By this time they will be able to possibly sit in the chair (or at east mum or dad’s lap) and even have a ‘count’ of their teeth.

Either way, our goal is to provide an environment where you child (of any age) feels comfortable in. Hopefully they will develop into a model patient with no fear or anxiety with their dental visits especially if you follow these few DOs and DON’Ts….

DOs

1. Talk about the dentist and surgery in a positive manner!

You can approach the subject at any time and the sooner the better, to instill a ‘no worries’ type of attitude. You can also discuss trips to the proper doctor in a similar manner. The more positive information your child absorbs the better the outcome. If you portray the scenario in a negative way (from perhaps a bad personal experience) then what do you expect will happen?

Reading books or checking out a video that show the people who “check to see if their teeth are healthy” is a great way of introducing the procedure. Click the images for links to these books.

The best video I have found to watch with your child is this one from the BBC television series CBeeBies the UK. The video was made in conjunction with the British Society of Paediatric Dentistry. It is very informative and the dentist uses the technique of “Tell – Show – Do” which in my opinion works extremely well on our younger patients.

Many of the US videos I have come across do not seem to use this technique and I see they just ‘dive in’ without explaining to the child, what they are going to do next! So, if you were to show your child any video at all, I think this is the pick of them…

If you personally come across any pamphlets, books or videos that you found helpful for your child, please feel free to let me know so I can include it here for others to check out.

WARNING! The following video link (Ren and Stimpy) is one to avoid at all costs! Tooth beavers do not exist!

2. Talk to the brothers and sisters before the appointment!

Please try to dissuade siblings from “winding up” their younger brother or sister as I know they may think it is bit of fun but it really is not helpful to a wary child. Rather, try and involve them by encouraging them to say what a fun experience they had themselves! Maybe watch the videos or read the recommended books together.

Better still, arrange their check-ups the same time so they can show the novice the ropes! Peer group pressure should not be underestimated, as the shy kids usually are fine after seeing their older sibling having a ride in the “chair that goes up and down”!

I remember that we had a young 7 year old girl who was so wound up by her older brother that she actually locked herself in the clinic’s toilet (restroom) rather than face coming into the surgery! Needless to say it has taken several years of coaxing to undo what a young child might have thought was just a bit of fun, yet it had such a profound effect on her younger sister.

3. Treat the whole scenario lightly!

It is a good idea to treat the visit as if you are just carrying out another daily chore such as going to the supermarket or bank or library or whatever. Just a new experience for them. If you build up the visit like it is something special such as Christmas or a birthday then your child may either be disappointed or be so nervous of the “big event” that they retire into shyness and nothing is achieved. Try not to make them the centre of attention (unless your child actually likes this).

With this in mind, many of my patient’s first experiences in the chair are at the same appointment as mum or dad’s check-ups. At the end of their appointment we often just casually ask if the child wants a ride in the chair like mum or dad, or indeed if they want a ride on their lap at the same time. If they accept the offer, then I show them a few of the tools like the mirror and the light and suggest they have their own special appointment to have another special ride in the chair on their own. Most agree and the ice has been broken!

If they let us count their teeth then that is a bonus, but I do not tend to push our luck. Every kid is an individual so we just play it by ear and test the boundaries of what they are comfortable with. It may not seem like a lot has been achieved but I feel, short 5 minute experiences like this can be very rewarding for all concerned. It is non-threatening and extremely productive. Many times I get a shy child in who would not say boo to a goose, yet I here from mum later that she would not stop talking about the visit and wants a ride in the chair next time.

For those too little to sit in the chair by themselves we try other ways to check them out!

Whether it is playing the upside down game…

or just tickling their teeth!

So I strongly advise that your child’s ‘first visit’ to the surgery/clinic is not specifically for them on their own. Just tag it on to your own check-up – (you may be surprised just how cooperative and curious they are. Combine this with a positive attitude from yourself and you will find most kids don’t have many of the hang ups that us adults have!)

Madison’s first visit-having teeth polished!

At the second appointment which perhaps now is more about them, they know the routine and we can easily introduce them to other tools such as the polisher or ‘counter’ (This is what we call the “probe” or in the US, the “explorer”). I do not like many of the first visit videos I have scoured on YouTube, expressly as they seem to brand this tool like it is a toothbrush!

It probably looks like the most threatening piece of equipment we have and I rarely use it at the first visit, especially on shy kids. So just think about what videos you do show your kids before the visit, as they pick up on little things like that “pointy stick”, where we see an innocuous tool! For this reason I recommend you stick to the video from the CBeebies as above.

One piece of advice though… If you have booked for your check-up and wish your youngster to tag along for a quick look, please advise the staff that you would like little Johnny to perhaps be seen also, so they can schedule the correct amount of clinical time. There is nothing worse than mum unexpectedly bringing in her twins for the first time at her own short check up appointment and expecting us to see them all- it just becomes rushed and counterproductive!

4. Keep it fun!

Show them the videos and books I have suggested, make light of the whole trip and you may be surprised to see a relaxed kid happy to sit in the chair and be entertained by that strange bloke or lady in the mask!

Remind them that they will be toys there and possibly colouring-in sheets (make sure to check there are, before promising this to them though, but most family dentists who cater for the young ones should have some distractions available).

Remember to take their favourite toy or doll to actually show the dentist (a great ice breaker) or even dress up for the trip. I have lost count of the number of superheroes, fairies and ballerinas we have had sitting in the chair (not only the kids!).

By the way, another thing that really does help when you get into the clinic, is to not answer for the child too much, if you can help it! Give them a chance to interact with the dentist even if it is as simple as when they are asking for their name and how old they are or what is their teddy or doll’s name – we don’t mind waiting whilst they are contemplating the answers. It just shows they are really listening and builds rapport with the dental staff, ultimately giving the child a feeling of comfort around older people.

One of the most rewarding part of my job is to see the siblings fighting over who wants a ride in the chair first!

This all comes from familiarity and making it fun!

DON’Ts

1. Don’t use Inflammatory or emotive words and phrases!

You need to be brave or

Don’t be scared

He won’t hurt you

You might not get the needle

Or the needle doesn’t hurt

It is natural to think that you are allaying your child’s anxieties and comforting them but use of emotive words and phrases such as pain, brave, hurt, needle and drill are often counterproductive. Look at it from their point of view… You are being taken to a new place to meet stranger who apparently has needles and drills but you needn’t be afraid as he may not hurt you!

Would you still feel like going!

2. Don’t make it such a big deal!

There is no need to build up the appointment to be some really big event where they are expected to perform or be on their best behaviour. I like to keep first visits casual and have no great expectation of the child to be the perfect patient. They are in a new environment, meeting some strange bloke or lady in a funny uniform and often wearing a face mask.

It is therefore not unexpected for them to be shy or reticent at first. I really do not like parents picking them up and plonking them in the seat. We are usually paddling up stream by that point unless the child does not mind!

If they are happy enough for us to have a look and count of their teeth then all good but sometimes I end up kneeling down on the floor with them checking out their teeth at their level.

The initial visits are all about acclimatising the child to this strange often confronting environment and it is not critical (unless they are in pain) to have a full thorough examination. This will come at subsequent appointments as the child becomes accustomed to the surgery and staff.

3. Don’t let ‘nanna-no-teeth’ take them to the appointment!

If your parents or grandparents unfortunately came from the era where dentists used to extract teeth rather than save them, and “prevention” was not really a buzz word at the time, then they may have a different mindset as to what is important about children’s dental health. This is no slight on them (more so on old dentistry!), but I really do like the first few visits to be conducted with the parent present if possible. You will get the information first hand without it being lost in translation, so to speak!

I find many people of this generation do not put as much emphasis on the importance of diet on young teeth. After all it does not affect dentures! I often hear grandma/pa rewarding the child for good behaviour (which I agree with) but with a trip to the lolly shop (which I do not agree with!) – at least it keeps us in business!

4. Don’t convey your own anxieties to your child!

Many adults for whatever reason, have had a less than happy time to the dentist! If this is you, please try not to convey your negative experiences to your child. Telling them that you had a terrible time when you last went but it will be OK for them does not really help much! So try and be bright and breezy when you come into the surgery. Saying “Oh, here we go again” or “this isn’t my favourite place” does not instill confidence in your toddler

There is really no reason for your child to come out of the appointments feeling like they do not wish to return. You can make a huge difference by changing your own attitude to the place. You never know, you may just enjoy your next appointment rather than fear it! Please do not underestimate the power of positive thinking! I know it sounds like hogwash but we see so much negativity in our profession that to be honest, when a parent comes in excitedly showing their kids the posters or fish tank or toy box, it just deflects all the negativity and we are already backing a winner!

A positive attitude to the dental environment by yourself,

is probably the best advice I can give,

to help your child accept and hopefully enjoy their first dental visits!

One more hint… If you can, turn up to the appointment with plenty of time to spare, especially if you have more than one child. Most dentists these days, run on a tight schedule. Your time is valuable and if you turn up late, chances are that you won’t get the most out of the visit without feeling rushed. Modern dentistry is expensive, so get the most out of your visits!

Turning up early gives you time to get all your prams and paraphernalia out of the car, use the bathroom, fill out the appropriate forms and even have time for the kids to enjoy the TV or toys provided. This all contributes to relaxing your children and you won’t feel so hassled getting them into the surgery.

Always remember though, if you think there is something wrong with your child’s teeth (chips or black spots) or they have toothache or bumped them, then do not hesitate to contact your dentists as soon as possible.

You should not wait for your regular check up. The visit may not be ideal but early treatment or advice is very important.

Also, it greatly helps if you can take a photo of the issue to send to your dentist so they know what to expect when you arrive!

Cheers for now!

If you have any specific issues you wish to discuss with me then feel free to